# HICKORY CREEK HEALTHCARE FOUNDATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hickory Creek at Lebanon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740214493
- **Authorized official:** MR. GARY BRENT WAYMIRE (VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (317) 570-0266

## Contact information

- **Practice address:** 1585 PERRY WORTH RD, LEBANON, IN 46052-9635
- **Practice address phone:** (765) 482-6391
- **Practice address fax:** (765) 483-2590
- **Mailing address:** 1585 PERRY WORTH RD, LEBANON, IN 46052-9635
- **Mailing address phone:** (765) 482-6391
- **Mailing address fax:** (765) 483-2590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | IN | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 08/22/2020